法舒地尔动、静脉给药治疗颅内动脉瘤栓塞后脑血管痉挛的对比研究

Comparative study between intra-arterial infusion and intravenous of fasudil treating cerebral vasospasm after intracranial aneurysm embolization

目的探讨法舒地尔动脉推注(IAF)与静脉给药对脑动脉瘤栓塞后脑血管痉挛(CVS)的疗效对比并评估其安全性。方法介入栓塞治疗后出现脑血管痉挛39名患者,随机分成A、B二组。A组,改用静脉法舒地尔治疗,30 mg,3次/d;B组立即行动脉内注射盐酸法舒地尔(60 mg+生理盐水100 ml,60 min缓慢推注治疗),连续3 d,3 d后予常规静脉法舒地尔治疗。结果 B组IAF治疗后血管痉挛程度明显改善,第3 d、7 d、14 d的GCS评分均高于A组,3月后GOS评分明显高于A组。结论 IAF能安全有效地缓解蛛网膜下腔出血后脑血管痉挛的临床症状并改善预后。

Objective To observe the effects of intra-arterial infusion of fasudil hydrochloride （IAF） to treat cerebral vasospasm （CVS） after intracranial aneurysm embolization compared with intravenous infusion and evaluate its safety. Methods 39 patients of CVS in diagnosis of aneurysmal subarachnoid hemorrhage （SAH） and treated by the interventional embolization were completely randomly divided into group A and group B. Croup A was to be received intravenous fasudil hydrochloride, per 30rag and 3 times a day. Group B had been immediately treated by IAF（6Omg ＋ NS 100ml,injected slowly for 60 minutes） for 3 days, recording the reactions occurred in the process of arterial injection. After the third day, received intravenous fasudil hydrochloride. Results The vasospasm degree had significantly improved in group B after IAF treatment. The GCS scores evaluated at the 3rd, the 7th day and the 14th day in group B after cerebral vasospasm were significantly higher than in group A. Group B＇ s GOS degree was obviously higher than group A＇ s after three months. Conclusion IAF can safely and effectively relieve the clinical symptoms of CVS and improve the prognosis.